There are plenty of articles and books that give a great deal of advice about starting a new job. First 90 Days by Michael Watkins and the Gartner First 100 Days were great preparation reads for me moving to my new role in Ireland. Now I am more than 20% into that first period of time, and getting back to normal after Christmas.
So after taking a little time to reflect on what have I understood so far and what I need to focus on for the next period I thought it would be good to try and set it out here.
The Gartner report suggests after day five you start to chunk up the first 100 days into 15 day blocks, which was great for coming back after the holidays and being able to see where we are going next, but for this blog entry I wanted to try and reflect on where you can get to with just 20 percent of the time!
Coming into a new job will rock even the most solid CIO I would guess, and if it doesn’t then maybe there is something of an over-confidence element at play or the CIO is in the wrong role! Coming to the Health Service Executive in Ireland, I am continually reminded, is indeed a big challenge. There is some significant work to be done, but I knew that when I applied for the job. I wonder if suppliers and commentators sometimes miss the fact that a CIO will obviously have done their research before taking on a job and therefore will know key things like the investment to date and the attitude to business change; however I am sure all of these comments have a genuine point at the centre of them which is to offer advice, guidance and an access to what has gone before, all of which has been invaluable in setting the tone for that first 20% of the 100 days!
Creating intent for the year ahead was a goal I set myself over the Christmas period. As a senior management team for technology we created a document that describes what our key functions will be and how we will deliver on some early elements of the eHealth strategy itself. In true organisational development style we have then been able to start to think through some of the formation elements as well, putting in place a design that allows agility within the structure without predetermining the outcomes of a large piece of business analysis that is underway, that will inform what will become the ICT Strategy. (Although by the time the strategy does come out I hope it has a different name!)
The strategic intent also has defined the six interim but key programmes that we will apply resource to at least in the first part of 2015, to get some immediate traction and results. These programmes are:
Health Identifiers: The delivery of Individual Health Identifiers to the population in a single index database that can be accessed from integrated systems throughout the Irish health system is one of the key foundations of eHealth. A first phase of this will be designed, built, tested and delivered before the summer of 2015.
eReferral: A very successful eReferral pilot had been completed in two areas of Ireland. Whilst not being able to deliver on the whole healthcare system-wide benefits it has delivered significant benefit into GP surgeries and has been a platform for engagement on the subject of digital supporting business change. With this in mind, one of the programmes will work to both continue the piloted roll out and consider what referral solutions could be deployed in a tactical manner later in 2015, that will release additional benefit across the whole system.
Primary Care Technology Programme: At recent events I have been able to talk about the ‘stars aligning’ in the delivery of our goals. That is never more so than in the Primary Care area. Changes in the market place, advancements in technology, a desire to deliver integrated care and the will of the clinicians involved all point to the possibilities opening up significantly in this area. With this in mind we are creating a piece of work to evaluate the art of the possible and define the needs.
Cancer Technology Programme: The delivery of technology today is important to the delivery of care in this therapeutic area. A group of clinicians have created a hugely impressive body of work that describes how technology could support the therapeutic area that means so much to them. To read this piece of work and see the vision, capability and desire to move this area into the current decade for technology inspired the creation of the Cancer Technology programme. This work will concentrate on ensuring that what can be delivered in this area in the next 12 to 18 months is done so with a mindfulness of technology strategy such as the identifier but with a core goal of releasing benefits to patients and clinicians alike as quickly as possible.
National Children’s Hospital Delivery requirements: No matter what the opening date for the NCH will be it will be the most advanced hospital Ireland has ever seen: a truly digital care facility that will integrate the pathway of care for children and enable a quality of care to be reached beyond what we can see today. To do that will require a technical capability in the integration of systems and information and therefore it is important that one of the strategic programmes is to design the response to this wonderful opportunity for the country.
Industry Engagement: A member of the audience at a recent event I presented at asked the very pertinent question, ‘Ireland is the centre of technology innovation in Europe, what are we doing to leverage that?’ What was great was to be able to answer that question with a tangible reality not just intent and plans. The team began an industry engagement programme in the late summer of 2014, to discover what the technology industry thought could be done to support the delivery of eHealth for Ireland. As a programme this has delivered a huge amount of clarity to the thinking of the team. Discovering how technology can be applied, procured and deployed will inform the delivery of the strategy greatly. This in turn will mean industry will be engaged as they will have been involved in its formation thus creating a virtuous circle of belief and capability to deliver.
Added to these strategic programmes, the intent also goes on to establish the need to provide a focus and governance on technology decisions which will be enacted through the creation of a technical design authority and a renewed focus on the delivery of a HSE-wide virtual Business Intelligence capability. This will build on the amazingly powerful Health Atlas solutions and the work done within the HSE in 2014, to consider what Business Intelligence functions and system need to look like to support delivery into 2020.
So for 20% of my first 100 days I have been really pleased with what we have achieved. We feel like a team with a goal and an ambition and, most importantly I would suggest, is that in everything we do we can see the impact on the patient and the clinician and the overall care system in Ireland.